# PRUCHNO MEDICINE LLC. / HEALTH TRANSITIONS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962934877
- **Authorized official:** WILLIAM A. CLAYTON (OFFICE MANAGER)
- **Authorized official phone:** (319) 247-3894

## Contact information

- **Practice address:** 202 10TH ST SE, CEDAR RAPIDS, IA 52403-2414
- **Practice address phone:** (319) 247-3894
- **Mailing address:** 202 10TH ST SE, CEDAR RAPIDS, IA 52403-2414
- **Mailing address phone:** (319) 247-3894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 132700000X | Dietary Manager | 079549 | IA | — |
| 133V00000X | Registered Dietitian | 079549 | IA | — |
| 133VN1005X | Renal Nutrition Registered Dietitian | 079549 | IA | Yes |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | 079549 | IA | — |

## Other

- **Enumeration date:** 03/30/2017
- **Last updated:** 03/30/2017